This proposal is in response to Request for Applications PAR-11-342 Neurological Emergencies Treatment Trials (NETT) Network Clinical Site Hubs for year 2011. This abstract summarizes the capability of the Ohio State University NETT network (OSUNETT) to: 1) develop a solid, cost-effective infrastructure that can quickly and efficiently implements both pediatric and adult acute neurological clinical trials; 2) To identify quickly, recruit aggressively, enroll efficiently and maintain and retain effectively the necessary study participants for each clinical study; 3) To coordinate the participation of multipl spokes in the network and ensure the safety and rights of all participants in the trials; 4) To collaborate with network members in developing and testing innovative telemedicine approaches to enhance informed trial consent process and patients follow-up; 5) To use the NETT initiatives and programs as a major component in training junior faculty, and research coordinators in the appropriate design and conduct of acute neurological clinical trials; and 5) To cooperate with other NETT Hubs in facilitating the transfer of research results to clinical practic in community hospital settings and among emergency medicine physicians. OSUNETT represents a multidisciplinary group of emergency physicians, neurointensivisits, pediatricians, neurologists, neurosurgeons, and trauma surgeons. This proposal builds on an existing research infrastructure that has supported acute neurological clinical trials both in the Emergency Department and in out-of-hospital setting using exemption from informed consent. OSUNETT has a well-established strong Hub-Spoke telestroke infrastructure with 14 spokes collaborating towards OSUNETT goals. The catchment area of OSUNETT extends over several counties with access to more than 3 million Ohio residents and more than 900,000 annual ED visits. OSUNETT is supported by 5 Level I Trauma Centers and 6 Primary Stroke Centers. OSUNETT has the experience, track record, and the support of a solid infrastructure to serve as strong participant in this important network. PUBLIC HEALTH RELEVANCE: Time is Brain. The optimal management in the first few hours of neurological emergencies is critical. Very few therapies have proven to be effective in part because the traditional approach for conducting acute neurological research is not well organized. The NETT network will provide the structure needed to implement efficacious treatments for patients with a broad spectrum of neurological emergencies in order to decrease associated morbidity and mortality. NETT should have a substantial impact on this important healthcare issue.